The One Key Report That Will Win a Social Security Disability Case

After over a 1,000 successful Social Security Disability cases, as a disability lawyer I have found there is one report that can make a difference. What is that report?

First, the agency considers the opinion of the treating doctor to be the most important document in the medical file. However, the critical opinion often does not exist. Why is this? Simply, doctors are involved in treatment. They are not concerned with legal disability issues.

Second, the agency will not allow doctors to make the legal determination in the case. Thus, if the doctor says a claimant is “disabled” the agency will reject this “naked” statement. The agency will say this is a legal determination to be made by the Social Security Judge.

Third, a mere statement that you are “disabled” will not be accepted. However, an opinion (from the treating doctor) stating what impact the claimant’s impairments have on important body functions can be extremely important and may be decisive in a case. For example, the doctor’s opinion on how long the claimant can walk, stand or sit is critical. Also, the doctor’s opinion regarding lifting, bending, etc. is critical.

Fourth, an experienced disability lawyer will have a set of evaluation forms for your doctor. They will be tailored for your individual impairment. For example, for a low back problem, there will be a lumbar spine form. This form will ask the doctor critical questions on how the low back problem impairs important body functions like walking, standing, sitting, lifting, bending, etc.

Fifth, unlike a “naked” statement of disability, this report will elicit what the doctor’s opinion is about the claimant’s ability to perform critical work activities. If the doctor’s opinion in this matter is supported by the doctor’s treatment records over a period of time, then the Social Security Judge may be compelled to give this report “great weight” in the claimant’s case.

Sixth, even if other medical evidence disagrees with the treating doctor’s opinion, the treating doctor’s opinion will prevail if the opinion is well supported by the treating doctor’s records.

In summary, a single report can win a Social Security Disability case. However, it has to fit the above criteria: (1) the doctor must be a treating doctor; (2) the opinion must indicate how critical body functions are affected by the impairment; (3) the opinion cannot just say the claimant is disabled; and (4) the doctor’s opinion must be grounded in the doctor’s treatment records. An experienced Social Security lawyer can work with the claimant’s to develop this winning report.

Here’s What You Must Know About Social Security Disability Insurance Law

If your medical condition prevents you from taking a job or find employment, you might be eligible to get disability benefits under the Social Security Disability Insurance Law. To qualify for Social Security Disability Insurance (SSDI), the Social Security Administration has set up a few norms.

– The person cannot work as before

– The person has a condition, usually physical disability, which prevents him in engaging in profitable activities to earn a living.

– The disability is expected to last at least for a year or has been the same for more than a year.

– The person has a disability that can eventually result in death

– The person cannot take up or adjust to a job, because the medical condition makes it hard to do so.

It might be confusing for people to understand if they qualify for SSDI benefits, which is why many choose to get in touch with a lawyer. As for the amount paid, it largely depends on the average of past earnings of the person. As for 2017, the monthly disability payment on an average was $1171, with maximum benefit reaching about $2,687.

When to seek legal help?

Thanks to the formalities involved, one can be denied SSDI benefits, and such cases are not uncommon. In fact, legal experts and lawyers can solve the issue for you. The first step is to understand if you are actually eligible to get the benefits under Social Security Disability Insurance Law. Your lawyer will explain everything in detail, following which the follow steps are to be taken.

– Completing the application. The paperwork involved in Social Security Disability Insurance Law application can be complicated at best. Many people are not sure of how to go ahead, which is why they seek legal expertise on the matter. The lawyer’s team can ensure that the trail of papers is completed as per requirements.

– Assistance with the reconsideration. Applications are often rejected, as mentioned earlier, and if that has occurred, do not panic or lose hope. Talk to your lawyer, who can file a request for reconsideration. Do not delay with the step, because the reconsideration request must be filed within 60 days after the first application is rejected.

– The third step is about Administrative Law Judge Hearing, which is required when the request for reconsideration is denied, as well. Another application will be moved by your lawyer before an Administrative Law Judge.

If your lawyer is competent, you can win the case in your favor in no time. It is important that you choose the right attorney for Social Security Disability Insurance Law application and follow-up procedures, if required. Take your time to evaluate the legal services available, and don’t shy away from asking relevant questions. Keep in mind that your lawyer can save considerable time and money, and their payments are usually linked with the services they provide. Ask for references and meet your legal team in person before taking the final call on moving an application.

When To Contact A Social Security Disability Attorney

People who are unable to work because of a physical or mental impairment can apply for Social Security Disability Insurance (SSDI) benefits. If accepted, the disabled individual will receive monthly payments from the government. Standards are quite high, however, and about 70 percent of initial claims for support are denied. In the overwhelming majority of cases, applicants are rejected because they failed to provide enough medical evidence to substantiate their disability.

What Constitutes A Disability?

For SSDI purposes, an individual is considered disabled if they suffer from a medical or psychological impairment that is so severe it prevents them from engaging in substantial gainful activity (SGA) for at least one year. At present, the monetary threshold for SGA is just under $ 1,100. So if an applicant cannot earn above that amount from his labor, he can apply for SSDI benefits. That does not, however, mean that he will be approved.

Can A Social Security Disability Attorney Help?

It may be disappointing, but having your initial claim denied isn't the end of the world. Many applicants successfully pursue their claims through the appeals process. Of course, it helps to have someone familiar with the process on your side. According to official data, over two-thirds of applicants who appeal their denial eventually receive benefits. But that can only happen if they have the information and evidence they need to prove their case. That's where a Social Security disability attorney can be invaluable.

It is important to note that not every claim for SSDI benefits should be pursued. If the Social Security Administration (SSA) had a valid reason for rejecting your request, a reputable attorney may not take your case. He or she may peruse your denial notice and inform you that your chances of winning are slim. If, however, your application was denied because you failed to provide medical evidence of your impairment, an attorney may accept you as a client. As such, he or she may submit new evidence for reconsideration on appeal.

The Odds Are In Your Favor

According to the SSA, more than two-thirds of the cases that come before an administrative law judge on appeal are approved. Why? The most obvious explanation is that most of the applicants at that stage of the appeal process have a reputable Social Security disability attorney by their side. These skilled legal professionals know how to present your case in a favorable light, providing proof of your impairment and the effect it has had on your life.

With results like those, you might be wondering why everybody doesn't hire an attorney to represent them? One obvious explanation is the price. Although their fees are often quite reasonable – generally less than 25 percent of back pay – not every applicant is owed a sizable sum. Only those who have not worked for quite some time and have been pursuing their case for many months may be eligible for substantial disability back payments. With that said, if you cannot work and do not expect to return to work for more than one year, you should seriously consider hiring a lawyer.

A Social Security disability attorney can help you win your claim for SSDI benefits.

What Does Disability Mean to Social Security?

Disability May Not Mean What You Think It Means

The word “disability” has a very specific legal meaning under the Social Security laws. To the average person, this can be confusing because Social Security’s definition may be different than the definition of disability under other disability laws and programs, such as worker’s compensation, temporary disability programs, long term disability insurance, special education programs, the Americans with Disabilities Act (“ADA”), the Department of Veteran Affairs, or the Division of Motor Vehicles definition when you obtain a handicapped plate. In fact, what your treating doctor or therapist thinks is a disability may not be the same as Social Security’s definition.

In other words, even if you are considered disabled by another government agency, insurance program or medical professional, this does not always mean you are disabled for Social Security benefits. If you are considering applying for disability benefits, you should not be discouraged by this information though because the fact that you were found disabled under some other program or by your own doctor may still be useful as partial evidence of your disability.

There are also non-medical and financial eligibility requirements for Social Security Disability Insurance (commonly referred to as “SSDI”, “SSD”, “Disability Insurance Benefits”, or “DIB”) and Supplemental Security Income (commonly referred to as “SSI”) benefits. The requirements are detailed and are beyond the scope of this article. This article is specifically only meant to address the medical eligibility requirements.

The Less Legal Explanation of Disability

Generally, Social Security will consider you disabled for both SSDI and SSI benefits if you meet all of the following criteria:

  1. you are not working or you are working but your earnings are limited (the earnings limit is set by the Social Security Administration, and for 2011, the limit is $1,640 if you are blind and $1,000 if you are not blind);
  2. you have severe medical conditions that are expected to last for 12 months or more, or are expected to result in death;
  3. your severe medical conditions significantly interfere with your ability to work;
  4. you can not perform the jobs you used to have; and
  5. you can not learn how to perform other less physical jobs, even if you never had any other jobs in your life (for example, even if you never worked in an office before, if Social Security thinks you are able to meet the physical requirements of a file clerk and they think you can be retrained to work in an office, then you will not be considered disabled.).

You generally have to meet all of the criteria listed in order to be found disability. However, depending on the type of medical condition you have and its severity, you may be eligible for disability benefits even if you have the skills to perform certain types of jobs as long as your earnings are limited.

Rules-of-Thumb

Below are some rules-of-thumb that may help make Social Security’s definition of disability more meaningful to you.

Scenarios where you may be found disabled

  • You may be found disabled based on having only one medical condition or on the combined effect of multiple medical conditions.
  • You may be found disabled based on having a physical and/or psychiatric medical condition.
  • You may be found disabled even if you have a poorly understood medical condition, such as fibromyalgia, migraines, or chronic fatigue syndrome. However, in these cases, there is probably a higher chance of being denied on the initial application, but with the right evidence, you may still be able to be found disabled on an appeal.
  • You may be found disabled, even if your medical conditions do not prevent you from working, but the treatments to control your medical conditions prevent you from working. Treatments like radiation therapy or chemotherapy with debilitating side effects, surgery with a very long rehabilitation time, pain medications that cause drowsiness or difficulty concentrating, or treatments that require regular overnight hospitalizations can all be considered by Social Security to find you disabled.

Scenarios where you probably will not be found disabled

  • You probably will not be found disabled, if your medical condition(s) will prevent you from working for less than 12 months. This is because Social Security disability was designed to cover only long term or permanent disabilities.
  • You probably will not be found disabled, if your medical conditions are under control with treatment and your treatments do not cause side effects that would prevent you from working. The Social Security system is concerned with the severity and frequency of the limitations caused by your medical conditions and treatments, not just having a medical condition, so if you are still able to work with proper treatment, you are not disabled.
  • You probably will not be found disabled, if you are able to work but you are having a hard time finding a job because of high unemployment. This is because Social Security was not meant to be a substitute for the unemployment insurance system. However, if you have significant impairments caused by severe medical conditions and you or your doctors are not sure if you are able to work, you may want to file an application for disability benefits or have your case evaluated by a Social Security disability lawyer.

Facts that are commonly (but incorrectly) thought to automatically prove disability

  • You are not automatically disabled if your medical conditions limit you to work that will pay less than your old job, even if your disability benefits would be higher than what you could earn in a lower paying job. When the Social Security Disability Insurance laws were first enacted in 1956, a fundamental concept was that a disability should be “totally” disabling. If you are still able to earn some money and it is over the earnings limit, then you would not be totally disabled. However, this analysis can be complicated and other factors, such as your age, past work experience and education, could still lead to an award of disability benefits.
  • You are not automatically disabled if you can not obtain health insurance. Unfortunately, the laws did not include the availability of health insurance as a factor to consider when Social Security makes a disability determination.
  • You are not automatically disabled if your medical conditions prevent you from driving. Under current interpretations of the law, the ability to drive may be considered as a factor when evaluating your case, but the inability to drive is not absolute proof of disability because there is typically a presumption that if you are still able to walk to work or to use public transportation, you are able to make it to work. However, why you are unable to drive is something Social Security will consider when evaluating how severe your limitations are

Although this is not a strict legal interpretation of Social Security’s definition of disability, hopefully, this will give you a general idea about what Social Security is looking for.